ABILITY READING COMPREHENSION IN PATIENTS WITH SPEECH AND LANGUAGE IMPAIRMENTS AFTER STROKE Goran Savić, Institute of Physical Medicine and Rehabilitation "Dr Miroslav Zotovic" Banja Luka, Republic of Srpska, Bosnia and Herzegovina, e-mail: sakogo@blic.net Background Impairments of speaking caused by stroke decreases ability to express and comprehend speaking, reading and writing. Alexia is loss or impairment of ability to read brought on by brain damage, in part with the Aphasia syndrome or other cognitive neurological impairments. Objective is to determine age, sex, education level, stroke aetiology, comorbidity, relation between locations of brain impairment after stroke with reading comprehension sentences and paragraphs in patients with impaired speaking communication. Patients and Methods During six months, 135 patients from Neurological ward of Institute for rehabilitation ''Dr Miroslav Zotović'' in Banja Luka, have been analyzed. Subtests of Boston Diagnostic Aphasia Examination (BDAE) were used. Aim is to determine age, sex, education level, stroke aetiology comorbidity, relation between locations of brain impairment after stroke with reading comprehension sentences and paragraphs in patients with impaired speaking communication. Method During six months speaking of 135 patients from Neurological ward of Institute for rehabilitation ''Dr Miroslav Zotović'' in Banja Luka, have been analyzed. Subtests of Boston Diagnostic Aphasia Examination were used. Results Average age of the patients was 66.77 years. In sample were more males than females. Lesions of brain were distributed on 35 different locations. The numerous were multifocal lesions. Than left sided lesions of parietal, frontoparietal, temporal, parietal temporal, frontoparieto temporal, para and / or supra ventricular and other brain regions. The lowest results were found on word-picture matching (average 45.40% of tests) and comprehension sentences and paragraphs (average 27,55% of tests). Understanding of read materials was lower at left sided compare to right sided brain impairments. There are high correlation between comprehension read materials with auditory understanding speech and language kao i ability nomination tested patients. Conclusion Ability reading comprehension in patients with speech and language impairments after stroke in examined sample is low. Degree this functions is depending at location and size brain damage and other factors. Key words: aphasia, stroke, brain lesion, alexia, comprehension reading Word-picture matching: Ten words are selected from card 5 to be identified on cards 2 and 3. One point is given for each correct recognition. Sentences and paragraphs: The examiner reads 10 sentences from cards 12 to 16. The client is requested to complete the ending of a sentence with a four multiple choice options. One point is given for each correct sentence. R e s u l t s F i g u r e no 1 The age and gender structure of the patients with speech and language impairments after stroke F i g u r e no 2 The presence of comorbidities, and stroke type of the sample Average age of the patients was 66.77 years. In sample were more males than females. Brain lesions were distributed on 35 different locations. The most numerous were multifocal lesions, than left sided lesions of parietal, frontoparietal, temporal, parietal temporal, frontoparieto temporal and other brain regions. The lowest results were found on word-picture matching (average 45.40% of tests) and comprehension sentences and paragraphs (average 27,55% of tests). Understanding of read materials was lower at left sided compare to right sided brain impairments. There are high correlation between comprehension read materials with auditory understanding speech and language such as ability nomination tested patients. T a b l e no 1 The educational level of the sample Education level of patients Frequency Percent Primary education 57 42.2 Secondary education 52 38.5 College, Faculty, master’s or equivalent level 13 9.6 Unknown Total 135 100.0 There is high correlation between results subtest BDAE Comprehensions Read Sentences and Paragraphs with results subtest BDAE Ability Responsive Naming (r =0.625); Naming of picture (r=0.690) and Naming of animals (categorical naming) (r= 0.665). Correlation is significant at the 0.01 level (2-tailed). T a b l e no 2 The success of the subtest Comprehensions read Sentences and paragraphs in relation to the location of the cerebral lesion F i g u r e no 4 Success on the subtest BDAE Comprehension read sentences and paragraphs in relation to neurological dysfunction side of the body F i g u r e no 3 Success on the subtest BDAE word – picture matching in relation to neurological dysfunction side of the body Location of brain lesion Success to 50% of the test Success more than 50% of the test Total Multifocal hotspot 20 13 33 Unknown location 9 3 12 Parietal left 2 11 Frontoparietal left Temporal left 7 1 8 Parietotemporal left 6 Frontoparietotemporal left 5 Para and Supraventrik. left 4 Area irrigation ACM left Frontotemporal left Basal ganglia left Basal ganglia booth side Frontal left Cerebellum right Insula left Temporooccipital left Para and Supraventric..right Paraventricular booth side Hypertensive encephalopathy Pons booth side Pons left Putamen right Supratentorijal Supratentorijal right Cerebellum Parietal right Parietal booth side Frontoparietal right Frontoparietotemporal right Parietooccipital left Basal ganglia right Supratentorial left Medulla oblongata Frontal right Parietal Temporal right Parietooccipitotemporal left 100 35 135 There is high correlation between Comprehensions read Sentences and paragraphs with results subtests BDAE auditory understanding: Word discrimination (r = 0.645; p = .000 ); Body part identification (r = 0.545; p = .000 ); Commands (r = 0.588; p = .000 ) and Complex ideational material (r = 0.645; p = .000). There is high correlation between results Comprehensions read Sentences and paragraphs with results subtest BDAE: Responsive naming (r =0.625; p = .000); Visual Confrontation (r=0.690; p = .000) and Animal naming (r= 0.665; p = .000). There is high correlation between comprehension Word-picture matching with results subtests BDAE Auditory comprehension: Word discrimination (r = 0.778; p = .000) Body part identification (r = 0.653; p = .000); Commands (r = 0.660; p = .000) and Complex ideational material (r = 0.719; p = .000). There is high correlation between results comprehensions Word-picture matching with results subtest BDAE: Responsive naming (r =0.745; p = .000); Visual Confrontation (r=0.798; p = .000) and Animal naming (r= 0.698; p = .000). Conclusion Ability reading comprehension in patients with speech and language impairments after stroke in examined sample is low. Degree this functions is depending at location and size brain damage and other factors.